The Ontario Nurse Transfusion Coordinators (ONTraC) Program is a Provincial Patient Blood Management (PBM) or Blood Conservation Program (BCP) that attempts to enhance transfusion practice by promoting alternatives to donor or allogeneic blood transfusion in surgical patients, improving patient care and well-being in a cost-effective manner.

Formed in 2002, the ONTraC program is a unique initiative supported by the Ontario Ministry of Health and Long-Term Care (MOHLTC) Blood Programs Coordinating Office (BPCO) to implement a peri-operative patient blood management program in 25 hospitals throughout Ontario. The institutions, large and small, were chosen on the basis of blood utilization and geographic distribution, and are a combination of teaching and community hospitals and represent approximately 65% of blood used in Ontario.

The program is coordinated through St. Michael’s Hospital by the Program Manager, Alanna Howell RN, and the Program Director, Dr. John Freedman.

Stop anticoagulants/anti-platelet drugs if safe to do so and directed by your physician

It is important that the Coordinator sees patients early enough (preferably at least 3-4 weeks before surgery) to identify patients at risk of transfusion ahead of surgery to allow for the detection and correction of anemia and development of an appropriate patient blood management plan.

Targeted data is collected during specified time periods on elective consecutive (by the OR date) procedures. Each site collects data on at least three or more of the following designated targeted procedures depending on the procedures performed and available resources:

Knee arthroplasty/replacement (TKA or TKR)

Hip arthroplasty/replacement (THA or THR)

Coronary Artery Bypass Graft (CABG)

CAGB plus valves (aortic and mitral valves)

Valves (aortic and mitral valves)

Radical Prostatectomy (RP) (discontinued as a targeted procedure in 2014)